Health maintenance organizations as Medicaid providers.

Evolution of a one-door, one-class system of medicine for all Americans was the professed goal of the social legislation of the 1960s. The development of health maintenance organizations (HMOs) was seen to be a major mechanism for assuring access to care and at the same time reducing the costs of social health programs. This has currently been reinforced by procompetitive proposals, which predict great efficiency resulting from the envisaged competition among organized systems of care. This article argues that established HMOs have no incentives to enroll Medicaid beneficiaries and that under current arrangements. Medicaid beneficiaries have no incentives to enroll in HMOs. As Medicaid programs across the states are cut, resulting in fewer benefits and more restricted physician payments, beneficiaries may have greater incentives to enroll in organized systems. Private physicians may also face greater incentives to develop HMOs to serve Medicaid beneficiaries. If that happens, however, a two-class system--one for the poor and one for others--will be institutionalized; and to assure minimum standards of care for the poor, more, not less, regulation will be required.     

A shared leadership model for human services program management

This article discusses the evolution of the Minnesota Parents’ Fair Share (MNPFS) program and to identify factors that have enabled the development of innovative practice in the delivery of a government sponsored human service program. The development and success of the MNPFS program is the result of utilizing contemporary models of shared leadership and enterprise management with committed frontline leadership from a variety of human service organizations. The MNPFS program is delivered and managed by frontline staff and leadership is shared by three Minnesota counties (Anoka, Dakota, and Ramsey) by staff from the courts, child support enforcement, income maintenance, and employment and training programs. Program services are targeted to unemployed or underemployed noncustodial parents whose children are on public assistance. The program is based on the assumption that children benefit when both parents contribute significantly to their children's economic and emotional needs.     

近期世界政党形势的六大看点

近来,虽然有的国家政局不稳,政党斗争较为激烈,但世界政党形势总体稳定。社会主义国家执政党突出抓党建和经济建设,巩固政权根基。发展中国家政党政治更趋成型。西欧政坛仍维持右翼占优的局面。一些国家即将进行新的大选,各政党为赢得选举正加紧备战,这些国家的政党形势正孕育着新的变化。     

The impact of administrative stringency on applications for the old age assistance program in new jersey

The purpose of this paper is to examine the impact of stricter eligibility enforcement on the flow of applications of the Old Age Assistance (OAA) Program in New Jersey.

Most of the previous research in the welfare area has focused entirely on explaining measures of the stock demand for public assistance. Higher claim denial rates may affect the stock demand by deterring those potential recipients with less legitimate claims. However, there is also a strictly mechanical relationship such that a claim period t or in state i reduces, pari passu, the stock demand in period t or in state i below the level that would have prevailed in the absence of the denial. Thus, if the objective is to isolate a deterence effect, it seems more appropriate to examine the impact of previous recent denial rates on the flow of new applications for public assistance. A time series of monthly applications for OAA in New Jersey are related to lagged values of the denial rate of such applications, cyclical activity, seasonal factors and trend. The results suggest that stricter enforcement of eligibility rules does deter future claims.